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Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection
BACKGROUND: We aimed to assess whether asymptomatic (“happy”) hypoxia was an identifiable physiological phenotype of COVID-19 acute respiratory distress syndrome (ARDS), and associated with need for ICU admission. METHODS: We performed an observational cohort study of all adult patients admitted wit...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047547/ https://www.ncbi.nlm.nih.gov/pubmed/35490510 http://dx.doi.org/10.1016/j.rmed.2022.106858 |
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author | Plummer, Nicholas Russell Fogarty, Andrew Shaw, Dominick Card, Timothy West, Joe Crooks, Colin |
author_facet | Plummer, Nicholas Russell Fogarty, Andrew Shaw, Dominick Card, Timothy West, Joe Crooks, Colin |
author_sort | Plummer, Nicholas Russell |
collection | PubMed |
description | BACKGROUND: We aimed to assess whether asymptomatic (“happy”) hypoxia was an identifiable physiological phenotype of COVID-19 acute respiratory distress syndrome (ARDS), and associated with need for ICU admission. METHODS: We performed an observational cohort study of all adult patients admitted with hypoxaemic respiratory failure to a large acute hospital Trust serving the East Midlands, UK. Patients with confirmed COVID-19 were compared to those without. Physiological response to hypoxaemia was modelled using a linear mixed effects model. RESULTS: Of 1,586 patients included, 75% tested positive for SARS-CoV-2. The ROX index was 2.08 min(−1) lower (1.56–2.61, p < 0.001) in the COVID-19 cohort when adjusted for age and ethnicity, suggesting an enhanced respiratory response to hypoxia compared to the non-Covid-19 patients. There was substantial residual inter- and intra-patient variability in the respiratory response to hypoxaemia. 33% of the infected cohort required ICU, and of these 31% died within 60 days. ICU admission and mortality were both associated with an enhanced respiratory response for all degrees of hypoxaemia. CONCLUSIONS: Patients with COVID-19 display a more symptomatic phenotype in response to hypoxaemia than those with other causes of hypoxaemic respiratory failure, however individual patients exhibit a wide range of responses. As such although asymptomatic hypoxaemia may be a phenomenon in any individual patient with hypoxaemic respiratory failure, it is no more frequently observed in those with SARS-CoV-2 infection than without. |
format | Online Article Text |
id | pubmed-9047547 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90475472022-04-29 Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection Plummer, Nicholas Russell Fogarty, Andrew Shaw, Dominick Card, Timothy West, Joe Crooks, Colin Respir Med Original Research BACKGROUND: We aimed to assess whether asymptomatic (“happy”) hypoxia was an identifiable physiological phenotype of COVID-19 acute respiratory distress syndrome (ARDS), and associated with need for ICU admission. METHODS: We performed an observational cohort study of all adult patients admitted with hypoxaemic respiratory failure to a large acute hospital Trust serving the East Midlands, UK. Patients with confirmed COVID-19 were compared to those without. Physiological response to hypoxaemia was modelled using a linear mixed effects model. RESULTS: Of 1,586 patients included, 75% tested positive for SARS-CoV-2. The ROX index was 2.08 min(−1) lower (1.56–2.61, p < 0.001) in the COVID-19 cohort when adjusted for age and ethnicity, suggesting an enhanced respiratory response to hypoxia compared to the non-Covid-19 patients. There was substantial residual inter- and intra-patient variability in the respiratory response to hypoxaemia. 33% of the infected cohort required ICU, and of these 31% died within 60 days. ICU admission and mortality were both associated with an enhanced respiratory response for all degrees of hypoxaemia. CONCLUSIONS: Patients with COVID-19 display a more symptomatic phenotype in response to hypoxaemia than those with other causes of hypoxaemic respiratory failure, however individual patients exhibit a wide range of responses. As such although asymptomatic hypoxaemia may be a phenomenon in any individual patient with hypoxaemic respiratory failure, it is no more frequently observed in those with SARS-CoV-2 infection than without. Elsevier Ltd. 2022-06 2022-04-26 /pmc/articles/PMC9047547/ /pubmed/35490510 http://dx.doi.org/10.1016/j.rmed.2022.106858 Text en © 2022 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Research Plummer, Nicholas Russell Fogarty, Andrew Shaw, Dominick Card, Timothy West, Joe Crooks, Colin Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection |
title | Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection |
title_full | Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection |
title_fullStr | Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection |
title_full_unstemmed | Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection |
title_short | Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection |
title_sort | silent hypoxia is not an identifiable characteristic in patients with covid-19 infection |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047547/ https://www.ncbi.nlm.nih.gov/pubmed/35490510 http://dx.doi.org/10.1016/j.rmed.2022.106858 |
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